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Most people that have heard about DIR/Floortime probably think about getting down on the floor and playing with your child. But there is more to Floortime in the Developmental, Individual differences, Relationship-based (DIR) model and it needs to be implemented properly to be effective.
First we need to understand what is so important about following the child’s lead. When you join the child in what they are interested in—even if it is running around in circles aimlessly—you are gaining insight into their emotional world.
So we want to sit back and observe what motivates the child. Next we want to ask “Why is my child doing that?” and assume that it is important and purposeful. That is, the behaviour is a form of communication, not an artifact of a diagnosis.
Recall our discussion about individual differences and sensory profiles. Our son has a need to throw objects every day. We can look at it as a nuisance—especially if he wants to throw something that is breakable or can break something or hurt someone. Or we can ask, “Why is our son throwing?”
When we do the latter, we respect him. We assume the throwing is purposeful. We now know that he has sensory needs that require him to move often and to throw objects.
That is, he might need to throw to stay regulated, which is the first and most necessary functional emotional developmental capacity. We have to respect this sensory need and figure out a way to fulfill this need–a need that is on par with hunger or sleep for children like ours. Suppressing it is not the answer.
The fine DIR therapists who have worked with our son have shown us how to redirect throwing into a constructive activity such as holding a big bin for him to throw objects into, or going outside to throw pinecones into the trees (one of his favourite activities).
The next step is to bring the child into a shared world, so continuing our pinecone throwing example, we might make a game out of it by taking turns throwing or playfully interrupting his throwing by saying “Hey! I want a turn!”
We always want to invite the child by woo-ing them into an interaction rather than forcing them. So we never grab them or turn their head towards us. We may playfully block them or stand in front of them to obstruct what they are doing so they have to acknowledge us, but we never want to force anything.
It is about respect. It helps to think about what we would want if someone were trying to get our attention. Would we want them to demand we look at them or physically turn our head? No! We will look and show interest if they are enticing us in some way. Same with our children.
Occupational therapist and DIR/Floortime Expert Provider and Training Leader Maude LeRoux gives an excellent example of joining a child who seems incapable of interacting.
One of her clients simply laid on the ground with a string. The parents said he never interacted. So Maude laid beside him and watched. Eventually she held up a string and imitated one action the child did.
The child was curious and looked. Next, she added one more piece, then another, until the child changed his movements to see how she would imitate them.
It was a great Floortime session in which the child felt safe enough to interact with Maude and she made him feel safe by not forcing anything or even saying any words.
Another important part of the Floortime session is tailoring our interactions to the child’s developmental level. (Recall the functional emotional developmental capacities from a few weeks ago). Note that Maude did not ask the child questions or even use words, which are higher developmental capacities. She started at the first capacity, bringing the child into a shared world, engaging the child, and eventually got a back-and-forth non-verbal interaction.
Floortime not only involves tailoring what we do to the child’s individual differences and developmental level, but we also want to be aware of our own strengths and weaknesses.
If we take the child’s rejection personally it might prevent us from being able to be respectful because we might become demanding of their attention, for instance.
If our natural state is very calm and the child is under-responsive, we might find it hard to engage them with the high energy necessary to entice him/her into an interaction. If our natural state is very loud or energetic and the child is over-responsive, we might find it hard to engage the child without over-stimulating him/her.
The key is to remember that every child wants to interact and be together.
It is our job to determine how to get the child to enjoy our company, not to blame the diagnosis for why they won’t interact with us.
What is motivating the child? How can we involve ourselves in that so they will feel safe enough to include us? What can we do to respect their individual differences or sensory needs? How can we challenge them a little more each time?
Finally, we need to reflect after each session to ask ourselves what went well and what we will do differently next time. “There is no rush in Floortime” Dr. Greenspan said.
Eventually we want the child to initiate the interactions. You can entice the child to do this by doing things a bit differently than you usually do. So if they are used to one thing, you might do it a bit differently and innocently ‘feign ignorance‘ so they have the chance to protest or problem-solve about what they want.
If this instigates a tantrum, you can instead create challenges for them. If they want something, you have already hidden it in a visible container so they have to problem-solve with you to get at it. If they want to go swimming, you innocently wonder and work through each step of what they need to go swimming, then get them to help you get them ready rather than just doing it for them.
We always want to respectfully challenge the child to relate, think, and communicate.
What’s great about Floortime is that you can do it anywhere at any time. You are simply trying to get the child to relate to you.
You are not having grand immediate goals with Floortime. The development will happen over time as you get the child to relate more and more.
Over the coming months, there will be video examples of how to do all of these things discussed above. Next week we will talk about Floortime as a Family Approach and how family dynamics can help or hinder Floortime.
Until next week, here’s to affecting autism!